Agenda Item 6. Implementation of the Political Declaration and Plan of Action on International Cooperation towards an Integrated and Balanced Strategy to Counter the World Drug Problem
By Dr. Lasha Goguadze, IFRC Senior Health Officer
Responsible for Global Harm Reduction and TB Programmes
Vienna, Austria │March 12 – 16, 2012
Madam Chair, Distinguished delegates,
It is with great honour and pleasure that the International Federation of Red Cross and Red Crescent Societies (IFRC) takes the floor.
Someone, somewhere, right now is in a basement room with a needle and a spoon, trying to take away the pain. It is estimated that worldwide 16 million people today are in such situation, a number equivalent to eight times the population of Vienna where we sit today. In the shooting galleries of the world, from Mumbai in India to Managua in Nicaragua ―where drug users are living underground for fear of being imprisoned, fined or discriminated against― the frequent use of shared and dirty needles is providing easy passage for the transfer of tainted blood from one body to another. It is simply the most effective way to spread the transmission of HIV and hepatitis C and reverse years of hard-won progress.
Taking drugs has escalated in recent years and it is a trend on every continent. When drug use is combined with selling sex to pay for drug habits, it creates a cocktail that massively increases the likelihood of spreading diseases to an unsuspecting public, added to exclusion, discrimination and stigma.
The last few years have seen enormous and welcome developments in drug policy. This is not only applicable to governments but also to our own network of Red Cross Red Crescent and we salute such initiatives.
Yet, in many countries the vulnerability of drug users and their needs are not recognized let alone met. They are rather viewed as criminals and not as a public health threat.
Madam Chair, ladies and gentlemen,
Let us go back to 2010, and recall the meeting on “Accelerating Implementation of Collaborative HIV and TB Activities for Drug Users” organised by the WHO European Office from 16-17 July in Vienna. At that time, the event has attracted 37 countries from all Europe, and one of its recommendations was for National health authorities to implement and scale-up a comprehensive package of nine interventions for harm reduction, preferably using "one-stop service" model, that include:
- Needle and syringe programmes,
- Opioid substitution therapy and other drug dependence,
- HIV testing and counseling,
- Antiretroviral therapy,
- Prevention and treatment of sexually transmitted infections,
- Condom programmes,
- Information, education and communication for drug users and their sexual partners,
- Vaccination, diagnosis and treatment of viral hepatitis
- Prevention, diagnosis and treatment of TB.
Unfortunately this key recommendation is hardly followed up or at least we are not aware of its implementation at a wide scale in Eastern Europe let alone worldwide. If we drill down to country level, and according to the latest UNODC figures, the prevalence of HIV among injecting drug users is extremely high, such as in Estonia (72 percent), Argentina (50 percent) and Brazil (48 percent)1. According to the UNAIDS 2010 report, in the Russian Federation, more than one third (37 percent) of the country’s 1.8 million injecting drug users are living with HIV. As the HIV epidemic spreads from people who inject drugs (predominantly male) to their sexual partners, the proportion of women living with HIV in the region is growing: by 2009, women represented 45 per cent of people living with HIV in the Ukraine, compared to 37 percent in 1999. And in Asia, about 16 percent of people who inject drugs are living with HIV. In some countries, this estimate is considerably higher: 30–50 percent in Thailand and 32–58 percent in Viet Nam.2
The level of HIV-positive among people who inject drugs is so high that some countries are edging dangerously close to generalized epidemic. Yet laws and policies continue with failed enforcement tactics.
We often ignore the evidence that to be successful in our drug policies, health services must provide a comprehensive package known as harm reduction programmes that combine the measures we have previously mentioned.
Instead, the best people who use drugs can hope for is to be driven underground to live with the addiction in the dark back streets and abandoned buildings of our towns and cities. Or even worse, they are criminalized and jailed with little or no regard for their healthcare rights or the impact of this policy on the health of their communities.
Madam Chair, ladies and gentlemen,
Left unchecked and untreated, drug use constitutes a serious public health concern that can only be addressed through rational public health services that act according to medical science rather than misinformed laws. Evidence points to the effectiveness of humanitarian drug policy. This is worth repeating. Harm reduction works.
This is why the IFRC - the world's largest humanitarian and development organization, a network of 187 societies of Red Cross or Red Crescent auxiliary to their public authorities in the humanitarian and development field and uniting tens of millions of volunteers half of whom are the youth - strongly call your excellencies to action.
The Red Cross Red Crescent, led by the Italian Red Cross Society, the mover and shaker of the Rome Consensus for a Humanitarian Drug Policy, back in 2007, developed such initiative to respond to the health disaster caused by drug use and drug addiction.
The Rome Consensus works with 121 National Societies and provides the support that enables National Societies to promote and implement a humanitarian response to drug use. It provides a framework that clearly lays out health principles and practices, information and research on drug consumption issues and best practices in drug policy responses and assist National Societies in implementing effective responses within their communities, bringing hence greater human dignity to people who inject drugs, that are shunned and excluded from the society and ultimately moving them out of harm’s way.
Treating drug addicts as criminals, is destined to fuel the rise of HIV and other infections not only among those unfortunate enough to have a serious drug addiction, but also for children born into addicted families and ordinary members of the public who are not normally exposed to HIV risks. Injecting drug use is a health issue. It is an issue of human rights. It cannot be condoned, but neither should it be criminalized.
Madam Chair, ladies and gentlemen,
To conclude, the IFRC, on behalf of the most vulnerable people affected by drug use, strongly calls upon key stakeholders and donors to exert all possible efforts to gather knowledge on the scale of the drug use epidemic at country level and decide on the proper response accordingly.
Criminalization, discrimination and stigmatization are not such responses. Laws and prosecutions do not stop people from taking drugs. Neither does the cold turkey methods of detoxification that can be potentially life-threatening. On the contrary, governments should recognize once and for that a humanitarian drug policy works!
Thank you Madam Chair.